The Key Update, Volume 3 No. 1, July 2006

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ANNOUNCEMENTS

An online registration form has been made available for this year’s
Alternatives Conference, to take place Oct. 25-29 at the Portland (Ore.)
Marriott Downtown Waterfront Hotel. The annual conference provides a forum
for consumers/survivors from around the country to exchange information
and ideas on peer-driven services, self-help, and recovery.

The UPenn Collaborative on Community Integration is offering consumer
scholarships to its conference, Sept. 19-21 in Philadelphia, on the
“National State of the Knowledge Conference on Increasing Community
Integration of Individuals with Psychiatric Disabilities.” The
collaborative is conducted in partnership with Horizon House, Inc.; and
the Mental Health Association of Southeastern Pennsylvania (MHASP),
umbrella organization for the Clearinghouse, which produces this
newsletter. The five-year collaborative is the first of its kind to focus
on community integration of people with psychiatric disabilities.

Applications for a limited number of scholarships are available at
http://www.upennrrtc.org/consumerscholarship.pdf. Applications must be
submitted by July 28, 2006.

NEWS AND REPORTS

The Bush administration announced on July 6 that it would exempt more
than 8 million of the 55 million people who receive Medicaid from a new
law requiring Medicaid recipients to document their U.S. citizenship or
lose their public health coverage. The 8 million people affected by the
administration’s action are those who had established their citizenship
during the application process for Medicare or Supplemental Security
Income, such as older adults and people with disabilities. The vast
majority of Medicaid recipients would still need to provide
documentation.

According to The New York Times, the administration’s action may be in
response to a class-action lawsuit filed June 28 that challenges the
constitutionality of the new law. Until the law took effect on July 1,
only those whose citizenship was in doubt were required to provide
documentation. Experts estimate that three million to five million people
may lose their Medicaid coverage because they are unable to document their
citizenship. The suit was brought by the Sargent Shriver National Center
on Poverty Law, the National Health Law Program, and the Chicago law firm
Goldberg, Kohn, Bell, Black, Rosenbloom and Moritz.

A U.S. Supreme Court ruling on an Arizona case involving a man who
argued that delusions caused by schizophrenia led him to shoot and kill a
police officer gives states the power to limit use of the insanity
defense. The ruling in Clark v. Arizona will allow states to preclude
defendants from presenting some evidence related to the defendant’s mental
state. In his June 29 opinion for the majority, Justice David H. Souter
wrote that the insanity defense was “substantially open to state choice”
and that Arizona’s rule would “avoid confusion and misunderstanding on the
part of jurors.” A dissent by justices Kennedy, Stevens and Ginsburg said
that restricting the evidence may not allow jurors in the Arizona case to
receive information needed to “make sense” of Eric M. Clark’s claims of
mental illness. Clark, who was a teenager when he shot the officer, is
serving 25 years to life.

In a June 30 decision, the Alaska Supreme Court ruled in favor of a
woman who argued that the state could not force-medicate someone when less
restrictive alternatives exist or unless it has proved that the treatment
is in the individual’s best interests. The Court’s long-awaited decision
in Myers v. Alaska Psychiatric Institute affirms Faith Myers’ argument
that forcing her to take mind-altering drugs would violate Alaska’s
constitutional rights to “privacy and liberty.”

According to a press release, Myers has not taken psychotropic
medication since 2001.

“By requiring the least intrusive alternative to forced psychiatric
drugging, this decision has the potential to change the face of current
psychiatric practice,” her attorney, Jim Gottstein of the Law Project for
Psychiatric Rights, Inc., stated in the release.

Between 1993 and 2002, there was a more than fivefold increase in the
use of antipsychotic medication to treat children and adolescents,
according to a recent report in the Archives of General Psychiatry. A
national survey found that such medications were prescribed to about 1,400
out of 100,000 youth in 2002. By comparison, from 1993 to 1995, 275
children of every 100,000 received such prescriptions. While experts have
argued insufficient research exists on the effects of antipsychotic
medication on young people to justify their use, others say that
antipsychotics are the best treatment currently available for children who
desperately need help.

A recent USA Today survey of U.S. Food and Drug Administration (FDA)
records between 2000 and 2004 found that atypical antipsychotic
medications were listed as the “primary suspect” in the deaths of at least
45 children and adolescents. About 1,300 other serious side effects, some
of which were life-threatening, were also reported. According to
OpEdNews.com, fewer than 10 percent of side effects and deaths are
captured by the FDA reporting system, so the actual numbers may be a lot
higher.

Sylvia Caras, a longtime consumer/survivor activist who created People
Who–an Internet “community” of “people who experience mood swings, fear,
voices and visions”--has received the 2006 Clifford W. Beers Award from
the National Mental Health Association. In her published acceptance
speech, Caras stated that the Internet, access to peers, access to ideas,
and access to information empower her “to make my own life choices, to
take pride in the results of the good choices and to learn from the
unintended consequences.” She urged others to “give that chance of
learning from mistakes, that chance for wisdom, to all people who
experience mood swings, fear, voices and visions.”

Travis County, Texas, will use a $500,000, four-year state grant to
create the Mental Health Public Defender Office, which will handle
misdemeanor cases involving people with mental illnesses. Its goal is to
divert clients from jail, although this may not always be possible, County
Judge Sam Biscoe told the (Austin) American-Statesman. Biscoe added that
the office expects to handle about 500 misdemeanor cases a year. Staff
attorneys will evaluate whether clients can receive probation and
placement into programs, depending on their history of criminal activity
and their degree of mental illness. The program--expected to be up and
running by November--is the first of its kind in the country, according to
Texas Appleseed, a public interest law center.

The Center for Health Care Strategies has chosen six states to
participate in its new Managed Care for People with Disabilities
Purchasing Institute. The aim is to help Medicaid managed care programs
improve services to people with disabilities. Each of the
states--California, Indiana, Nevada, New York, Pennsylvania and
Washington–is working to create, implement, or expand its Medicaid managed
care program to include people who are eligible for Supplemental Security
Income (SSI). The states will receive technical assistance and training
for two years, on subjects including developing outcome measures tailored
to people with disabilities. The results of the initiative, supported by
the California HealthCare Foundation and the Robert Wood Johnson
Foundation, will be shared with other states. Sources: http://www.chcs.org/info-url_nocat3961/info-url_nocat_show.htm?doc_id=359008New
York Association of Psychiatric Rehabilitation Services e-news * * *

A recent UPI article on the benefits of peer support services quoted
Joseph Rogers, president and CEO of the Mental Health Association of
Southeastern Pennsylvania (MHASP) and executive director of the National
Mental Health Consumers’ Self-Help Clearinghouse, which produces this
newsletter. Speaking at the National Mental Health Association conference,
Rogers said, “Peer specialists give hope to people about recovery because
they are walking, talking examples of recovery.” He added that peers fill
gaps in the mental health service system, which is often not
recovery-oriented. The article addressed the success and
cost-effectiveness of peer support, and cited the Certified Peer
Specialist program that MHASP has developed in Pennsylvania, and an
initiative in Georgia, which was the first state in which peer support
services became reimbursable by Medicaid.

RESOURCES

The Substance Abuse and Mental Health Services Administration (SAMHSA)
has published a curriculum that offers strategies for reducing the use of
seclusion and restraint. The agency’s “A Roadmap to Seclusion and
Restraint Free Mental Health Services for Persons of All Ages” is intended
for direct-care staff. It is offered in CD-Rom format and includes
complete lesson plans and handouts for each training module. The
curriculum is available at the link below:http://www.mentalhealth.samhsa.gov/publications/allpubs/sma06-4055/

An 18-minute online video that is designed to improve mental health
professionals’ skills in forming therapeutic relationships, as well as
giving viewers insight into consumers’ feelings about their relationships
with their therapists, is available from the Substance Abuse and Mental
Health Services Administration’s Resource Center to Address Discrimination
and Stigma Associated with Mental Illness (ADS Center). In the video,
psychiatrists and people who have mental illnesses talk about what helps
and what hinders in creating therapeutic relationships that foster
recovery. To view the program, visit http://www.stopstigma.samhsa.gov/partnersinrecovery.htm

“Consumers in the Mental Health Workforce: A Handbook for Providers,”
by Wilma Townsend, M.S.W., and Grisetta Griffin, provides direction on how
to effectively recruit, manage, integrate, and retain people with mental
illnesses as staff in behavioral healthcare agencies. Among the topics it
covers are the benefits of hiring consumers, the hiring process, and
questions about management, including reasonable accommodations and
professional development.

The Clearinghouse welcomes all programs in which consumers play a
significant role in leadership and operation to apply for inclusion in its
Directory of Consumer-Driven Services. The directory, accessible at
http://www.cdsdirectory.org, is searchable by location, type of
organization, and targeted clientele and serves as a free resource for
consumers, program administrators and researchers.